Community Conversations Spring 2010

1. Guysborough County Antigonish Town and County Strait Richmond Community Health Boards Presentation Staying Healthy Together, April 7, 2011 Community Conversations Spring 2010

2. Planning Process • Gathering information through community engagement • Workshops to develop the plan • Identify Strategic Directions and Recommendations • Develop CHB Operational Plans

3. How did we engage the community? • Community Conversations • Understanding Our Health Survey • Presentations from GASHA Departments and Community Agencies • Direct links to community organizations and coalitions • Reviewed other information and relevant reports

4. Community Conversations - Purpose • Provide information and discussion on important health issues • Identify factors affecting health • Identify and prioritize the serious health issues • Identify some ways to address health issues • Identify effective communication strategies

5. Community Conversations • 40 Focus Groups held across the district – 36 reports • 344 participants • Included geographic communities as well as specific populations: youth, young families, seniors, African Nova Scotians, Acadian/francophone and First Nation communities, the business sector, and community agencies.

6. Lack of Physical Activity- 50% (18/36) For Youth, Seniors and Young Families • Access to motivational fitness and wellness leaders (ATC; SR) • Organized recreational activity in local communities (SR; ATC; GC); • Leadership by those responsible for recreational activities (ATC); • Young people need more physical activity (ATC; SR); • Safe walking routes for seniors (ATC); • Accessible, affordable, local, and age appropriate programs and facilities, including attention to the needs of seniors (SR); • Equipment, education, and some organized fitness programs Introduce equipment better and at younger age (GC).

7. Poor Nutrition – Obesity: 78% (28/36) • Poor nutrition, unhealthy eating, poor eating habits (ATC; SR; GC); • Lack of awareness of healthy food choices (GC.); • Need good reliable information and knowledge of community gardens (ATC; GC); • Easy access to junk food and convenience foods (ATC; SR); • Use of technology encourages inactivity and bad eating habits (ATC; SR); • Lack of access to healthy food choices (GC).

8. Need for Prevention & Wellness:39%(14/36) • Need prevention and wellness activities in our communities (SR; ATC); • Need for awareness and education about benefits of changing lifestyles (GC); • Need more focus on relationship between physical activity and wellness (ATC).

9. Need for Supportive Environments: 39% (14/36) • Need support systems and motivation to facilitate understanding that change is required (GC); • Need support from friends, family, and extended family; for example, not giving kids unhealthy food. (GC.); • Need to support and motivate youth (GC.); • Need increased workplace wellness, physical activity opportunities at work, and support for employees and employers; for example a tool kit for employers (SR).

10. Addictions & Substance Abuse: 56% (20/36) • Drugs, alcohol and gambling, both youth and adults (SR); • Drugs, smoking, alcohol concerning to youth (ATC); • Many adults are smoking and using drugs and alcohol (GC); • Access is easy for youth. Adults help youth get drugs, alcohol and cigarettes (GC); • People have multiple addictions (GC); • High percentage of youth in school smoke (GC); • Smoking an issue, especially with young families (ATC); • Peer Pressure – youth want to fit in (GC); • Starting younger in usage (GC); • Lack of enforcement by police for smoking underage (GC).

11. Chronic Disease: 50% (18/36) • In all three CHB areas, diabetes identified as a health issue; including, African Nova Scotians and First Nations communities. • In the Guysborough CountyCHB area, cancer, and heart disease were also identified as priority health issues. • In Antigonish County, cancer was identified as the top priority health issue by one focus group.

12. Lack of physical activity Obesity, poor diet and lack of awareness of healthy food choices Mental health issues, such as stress Drugs, drinking and smoking Lack of education and information Access to services and transportation Lack of supports, programs and isolation Lack of motivation; people have difficulty making changes Economic issues, low and fixed income; high cost of healthy food and drugs Pollution Factors Affecting Chronic Conditions

13. Mental Health – 58% (20/36) Factors Contributing to Mental Health • Isolation and loneliness, particularly for elderly in rural communities; • Stress and time management for students and young families; • Relationship between mental health and having a chronic condition; • Other factors such as economic stress, relationship issues, racism, stereotypes/stigma, low literacy, lack of physical activity, and family history.

14. Mental Health – 58% (21/36) Access to Services • Lack of self awareness about mental health status and conditions, hence the need for “mental health literacy;” • Lack of awareness about services available; • Stigma remains a barrier to accessing mental health services; • Need for more community-based programs, support and self help groups; First Nations Communities • Report mental health as a major health issue. Discharge planning is of particular concern. • Memorandum of Understanding (MOU) - mental health one area outlined for action

15. What We Heard from our Consultation - Access Key challenges: • Growing seniors population requiring supportive environments • Homecare requires improvements • Public transportation • Better access to health information and services & programs • Community-based services & programs closer to home • Continue to improve services to communities that have been historically excluded and marginalized • Implementation of Dr. John Ross report will require full community consultation and attention to recruitment and retention of staff.

16. Growing Aging Population Homecare Elder abuse Poverty Cost barriers to programs & services Lack of communication & awareness about services & programs Adequate, affordable housing Rural transportation Safe places for walking & physical activity Housing supports for snow removal, lawn mowing, etc. Isolation: support systems for elderly and caregivers; smaller families and people moving away. Seniors – Supportive Environments 39% (14/36)

17. Access to Homecare • Gap in supportive care upon leaving hospital and returning to home (ATC); • Cost of and access to adequate caregivers which would allow seniors to stay in own home (ATC); • Need support systems for elderly and their caregivers (SR; ATC); • Home care services received are very limited and need to be expanded (SR); • Housing supports for seniors and individuals living by themselves for snow removal, lawn mowing etc. (SR).

18. Transportation – 58% (21/36) Antigonish Town & County CHB area: • Affordable and accessible transportation - over ½ of focus groups. Lack of rural transportation, especially for seniors. Strait Richmond CHB area, • Affordable transportation – in particular lack of access to services Guysborough County CHB area - one of priority health issues • Lack of transportation to appointments, clinics and education programs as well as lack of access to programs and facilities. • African Nova Scotian community of Lincolnville- lack of public transportation major issue in accessing services and programs as many residents do not have cars.

19. Communication and Engagement 47% (17/36) • More information about community programs & services in local communities (GC; SR; ATC); • Access to health information (AC; SR; GC) • More promotion on what to do to improve health (SR). • Suggestions to promote programs and services: brochures in communities; information on internet and website; CAP sites to have safe health links; pamphlets available on reliable health links; promotion of the 811 service. (GC; SR; ATC);

20. Supportive Environments for Young Families: 28% (10/36) • Child and parenting supports • Child care in order to access programs • Locally organized recreational activities • Isolation and stress - many young mom’s are on their own – ‘single moms’ while partners are working away • Need to keep young families in our communities through support for economic sustainability

21. Community-based Services/Programs 83% (30/36) • Chronic disease programs/self help groups, support programs (ATC, GC, SR) • Health education (ATC, GC, SR) • Screening programs - monthly clinics (ATC, GC, SR) • Outreach health and wellness programs (ATC, GC, SR) • Expanded hours at existing walk-in clinic; more walk-in clinics and clinical services, youth health centres (ATC, GC, SR) • Community gardens; good nutrition, meal preparation, healthy meal planning (ATC, GC, SR)

22. Health Inequities Physical & Built Environments: 22% (8/36) Strait Richmond CHB area: • Safe drinking water; particularly well water; education about water testing; cost for well water test can be a barrier to testing. Guysborough County CHB: • Education and better information about well water testing and how the test works. • Lincolnville identified insufficient water supply as one of their priority health issues. Strait Richmond andAntigonish Town & County CHB areas • Safe areas for walking, particularly those living in rural areas.

23. Health Inequities – Poverty/Income 39% (14/36) In all three CHB areas, poverty identified as a factor affecting health and linked to a number of other factors as follows: • Food security and ability to buy nutritious food; • Ability to access to services due to lack of transportation, especially in rural areas; • Adequate and affordable housing; • Ability to access recreation opportunities; • Ability to participate in programs due to cost barriers; • Access to prescriptions due to costs.

24. What We Heard from Consultation: Youth (7 gps) • Most common health issues: (1) mental health (2) drugs, smoking and alcohol; and (3) obesity. • Need places for youth to gather – youth health centres & after school recreational and social activities • Affordability & transportation in rural areas critical to engaging youth • Need to improve physical activity levels • Healthy eating/obesity need to be addressed • Readiness for change to improve health and wellbeing - identified factors to help increase physical activity levels • Reseau Sante – Nouvelle Ecosse youth focus groups similar issues

25. Strategic Directions 1. Strengthening & Supporting Mental Health in Our Communities 2. Implementing a Comprehensive Community-based Chronic Disease Strategy 3. Promoting & Supporting Healthy Living 4. Building Bridges to Youth Health 5. Facilitating Access to Services & Programs 6. Addressing Inequities to Improve Health 7. Promoting Communication with Communities & with GASHA 8. Enabling Health Planning & Coordination

26. CHB Focus Group Conclusions • Results reinforced issues from Understanding Our Health Survey • Multiple factors contribute to health of populations (seniors, youth, those living in poverty) • Access and health inequities critical to address in rural areas • Need to consider determinants of health and health inequities in delivery of all services • Need to focus on youth as our most critical health promotion and prevention strategy. • Recommendations: community-based and collaborative services will ensure more wholistic approach to improving health

27. Thank you! Questions Comments